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Saturday
Apr102010

The Virtue of Complaining

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By Emjaybee

ICAN has posted a list of things you can do to complain about your mistreatment during a birth. It’s helpful and necessary, but also a little discouraging.  Affecting hospital policy and practice from the outside is still a hard slog, and lawsuits for unnecessary c-section are difficult and expensive to bring. At the moment all we can do is file complaints, educate others, and push for legal reform.

The most effective wedge right now seems to be pushing for wider access to midwifery and/or birth centers, because while you can’t tell doctors or hospitals what to do, you can shake things up by introducing medical practitioners like midwives who challenge them by providing better and more satisfactory care.

On that note, you can contribute to groups like the M.A.M.A. Campaign (full disclosure: I do some volunteer work for them, and ICAN too) and the Big Push for Midwives as another way of fighting back.

But there’s a larger issue in all this for me.  Women are generally taught that no one likes a complainer. Fairytales are full of heroines who take all kinds of crap with a smile and song, waiting for their prince to show up and make it All Better.

It’s hard to imagine a more pernicious lie to tell to anyone.

Here’s the real truth; until women complain, and complain loudly, for a long time, in ways that anger people and make them uncomfortable, nothing ever changes. It took nearly a hundred years (1826 to 1920) for the first public calls for women’s suffrage to become women’s right to vote. In that time, women were mocked, arrested, and shamed for wanting something so simple and basic as the right to vote on their own behalf. Whole books were written, speeches were made, rude songs and poems and cartoons were created, that portrayed women’s desire to have a vote as something unnatural, un-Christian, and destructive to society. But they didn’t give up, and eventually they won.

And nowadays we look back in amazement that anyone ever found women voting controversial.

I don’t think our fight for better treatment of women in birth will take that long; we have better tools (including our votes!) and more resources than any woman did 100 years ago. But we are still very much in the making-speeches, writing-letters, raising-a-stink phase, and we’ve still got a ways to go to secure our rights and change the system.

I’m saying all this to remind you that when your demands for your rights, the rights you know all women deserve, makes others uncomfortable, or makes them try to shame you for wanting “too much” or “in the wrong way” or for being a “complainer” or “shrill”, then they are using very old tactics. Tactics designed to make you go away and give up and leave things the way they are.

“Sit down and shut up, we know what’s best” is not the honest argument of someone who wants to find the truth. But it still gets said to women who are pregnant and in labor, in ways big and small.  And the only way to fight that kind of attitude is to not be afraid to complain, and demand, and make a nuisance of ourselves until change happens. 

I really believe that someday, our daughters or granddaughters will be amazed that any woman was ever arrested for refusing a c/section, or operated on against her will, or prevented from moving or eating or making noise while she labored to birth her baby. They’ll regard much of what is still considered normal today as cruel, and uninformed, and backwards.

And they’ll be right. But only if we keep refusing to silenced.

 

  

 

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Reader Comments (9)

I think there's a way, honestly, to "contend without being contentious". While it's true that I honestly don't give a rat's ass if some hateful misogynist thinks I'm a shrew or a bitch for complaining, I also don't want to unnecessarily alienate people by being combative. Rightly or wrongly, the feminist movement has lost a lot of my generation because of the perception that feminism turns women into shouty, bitter shrews. I don't want to see the same thing happen with birth advocacy.

Anyway, thanks for writing this, emjaybee, and for all of your excellent contributions here, in fact! It's important to be reminded of what's at stake AND of the very real obstacles we face. *applause*

April 10, 2010 | Unregistered CommenterLaura

What about those who don't complain? Who don't realize their cesareans and interventions weren't necessary? My friend gave birth last week by cesarean. Her baby was "measuring large" (actual birth weight was 7lbs, 6 oz,), she had a yeast infection that "might not be cleared up before delivery" and of course there was a "risk of shoulder dystocia" (with a 7 lb baby? Not any more than with any other average delivery).

I did direct her to a bunch of resources about shoulder dystocia, but she was having none of it and after her water broke at 38 weeks she was rushed in for a c-section. I'm kind of heartsick, but she seems to think it's fine. Perhaps I should let it go because it's not my birth experience, but I just feel so unbelievably sad about the whole thing.

So I suppose my question is, what more can be done about the culture of maternity care so more women realize they have something to complain ABOUT?

*sigh*

April 10, 2010 | Unregistered Commenterelizabeth

elizabeth--this comes up on my ICAN list frequently. But we basically take our cues from other kinds of therapy, in that you cannot make someone's choices for them. She will or will not come to agree with you about her c/sec, and in the long run, you do have to let that go. It's her experience and she's the only person who can decide if she thinks everything that happened is ok.

And besides, even if everything were great and we had midwives and birth centers on every corner and the c/section rate was down to 15%--there would still be the occasional woman who made birth choices you thought were unhealthy. We have to look at the bigger picture, at making an overall difference and increasing choices, and not so much at trying to make everyone think alike. We aren't trying to make everyone have the same awesome birth, but to make it possible for *many more* women to have good births because they are respected, cared for, and educated about their options.

April 10, 2010 | Unregistered Commenteremjaybee

Right on. Keep fighting the good fight.

April 11, 2010 | Unregistered CommenterRachel

Hopefully what you say is true: that in a few decades? maybe, our daughters and granddaughters will look on this and see physical violence. Either that, or they'll wonder why ANY woman would want to give birth vaginally. After all, some physicians predict that everyone will give birth by c/s.

I was thinking about this post earlier and the women I know who don't question, who are "too polite to fight" (as your earlier post describes). They are often motivated by one thing: fear. Fear is a tremendous tool that many OBs wield with great success. Out of all the technology and tools they have, fear is the greatest tool they possess in getting us to comply. Even those who know better and stand up for themselves. There's still that grain of truth that says they just might be right.

Elizabeth, I know where you're coming from. It's so frustrating and sometimes you just want to scream. Because, really, of those women who don't know, don't care, are too polite and won't complain, we are seen as the anomaly. The "b!tch" who puts up a fight for things that others don't consider a big deal. We are all treated the same, sadly, rather than seen as individuals with different bodies, different pregnancies. We are all taught how different we are; even told so by our doctors, until it comes to this one thing: birth. Doctors expect us to want the same kind of birth as the 100 other women who have walked in the door hours before, only we don't. I am convinced that, with a little education and some guts, those 100 other women wouldn't end up wanting a birth that way, either.

April 11, 2010 | Unregistered CommenterThe Deranged Housewife

Yes! Score! *air punch* We are so well socialised to avoid conflict of any kind even when inside we're screaming no. Taking back our power by agitating for change and saying no to misogyny is about the best gift we can ever give ourselves and each other.

April 12, 2010 | Unregistered CommenterJanet Fraser

Amen!

April 12, 2010 | Unregistered CommenterEmily

So, so true! Great post! And way to keep a positive attitude. It's hard for me to feel positive when there are so many things in the system that are just plain wrong - attitudes, policies, rules, traditions are all fighting women's needs. And then, as Elizabeth pointed out, women are so often willing to lie down and do whatever they are told when it comes to birth. *sigh*

I try to remind myself that in the last few decades, we really have made strides. Seldom are women forced to deliver vaginally by forceps while knocked unconscious, as my MIL was. Husbands and sisters and friends are now allowed in the delivery room. In most places the mom actually gets some (though not enough) access to her baby. We just have farther to go....

April 13, 2010 | Unregistered CommenterKaren

This is so true for many aspects of healthcare for women. These days I've learned to take my husband along to all critical appointments to act as the "appeal to irrelevant authority" because, no matter how rationally and persuasively I speak, my concerns and questions are dismissed, especially if a health care provider sees that I'm taking an SSRI. Postpartum, I was singled out for "extra support" (i.e. intrusive, rude questions and insinuations that I was unfit to be a mother) by the nurses, who insisted I must suffer from major depression, despite my continued explanation that my diagnosis is and always has been PTSD (not that there's anything wrong with having depression -- it's just that they refused to believe me).

But this kind of dismissal of women's complaints can be dangerous. Yesterday I saw one of the partners in my OB's office for the first time, and he recommended starting a new medication, but at a dose 10x what I had used when taking the drug a few years back. I questioned him closely about the dosage, telling him I'd never taken anywhere near that much, and he just insisted that I must have not been taking enough before! The pharmacist remarked on the dosage, but filled the prescription since it was not a lethal dose... Uneasy, I checked the prescribing information and found out the maximum recommended dosage was only 40% of what he prescribed, and that the usual dosage was 100 mg, not 1 g (1000 mg! -- that's a factor of ten off). Knowing the doctor would blow me off again, I didn't take the drug and called the pharmacist back and asked her to speak to the doctor, which she did. Not ten minutes later, I got a call from the doctor insisting that the pharmacy must have made a mistake, since he uses that drug "all the time" and would "never write for that strength -- ever". He denied that I had questioned the dosage -- and then the fax machine spit out a copy of the prescription in his handwriting (my pharmacist is awesome!), and suddenly the whole tone of the conversation changed. Now I got a rather horrified apology and a little grudging respect when I proved able to discuss chi-square analysis and underpowering of small retrospective studies without having my brains explode :-).

The mistake was not what I'm angry about -- these things happen, and it could have been catastrophic for my baby and potentially my health, but there is no human so perfect that he cannot make a mistake. My anger is for the arrogance that doctor exhibited in refusing to consider that he might be making a mistake despite my questions. Why did it take a pharmacist calling him for him to pull his head out of his rear end? A quick check of easily available references while I was in the office would have either proved my concerns groundless or prevented a potentially catastrophic error.

Sorry, a bit long-winded, but I feel very strongly about this topic :-).

April 15, 2010 | Unregistered CommenterAlice
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